1. Field of the Disclosure
This disclosure relates to an apparatus and method for measuring the level of flammable gases in relation to the zone of a surgical procedure such as electrocautery. More specifically the disclosure pertains to minimizing inadvertent activation of energizable surgical tools such as an electrosurgical pencil, a laser scalpel, and more particularly a safety switch arrangement.
2. General Background
In general, there is a problem in minimizing surgical fires. In the fire triangle heat, fuel and oxygen are present to start a fire. All too often all three elements come together in a hospital's surgical suite, yielding disastrous consequences. Surgical fires are one of the most frightening and devastating experiences for everyone involved. Of more than 50 million surgeries performed each year that there are approximately 500-600 surgical fires each year, resulting in up to 60 serious injuries and one or two patient deaths annually.
The cause of the fire can be attributed to activities relating to a side of the fire triangle. The most common ignition sources are electrosurgical equipment (68 percent) and lasers (13 percent). The most common fire location is the airway (34 percent), head or face (28 percent), and elsewhere on or inside the patient (38 percent). An oxygen-enriched atmosphere was a contributing factor in 74 percent of all cases. Ignition of flammable gases was implicated in many of the fires.
A host of flammable materials are found in the surgical suite, from the wide range of alcohol-based prepping agents, nitrous oxide, hydrogen, methane, and linens such as drapes, towels, gowns, hoods and masks; to the multiple types of dressings, ointments and equipment and supplies used during surgery.
Common ignition sources are electrosurgical or electrocautery units (ESUs, ECUs); fiberoptic light sources and cables; and lasers. In addition, ESUs, lasers and high-speed drills can produce incandescent sparks that can fly off the target tissue and ignite some fuels, especially in oxygen-enriched atmospheres in association with other flammable gases.
The disclosure relates to improvements in the operation of electrosurgical instruments for coagulating and cutting biological tissue. In particular, the disclosure relates to a device for enhancing the safety and efficiency of a hand-operated electrosurgical handset, which is used to perform the desired coagulation by electrosurgical fulguration or to provide electrosurgical cutting, and to an improved method for performing electrosurgical operations in the abdominal cavity.
Electrosurgical fulguration comprises the application of electric sparking to biological tissue, for example, human flesh or the tissue of internal organs, without significant cutting. The sparking is produced by bursts of radio-frequency electrical energy generated from an appropriate electrosurgical generator. Generally, fulguration is used to dehydrate, shrink necrose or char the tissue, which operations are primarily to stop bleeding and oozing, or otherwise to seal the tissue. These operations are generically embraced by the term “Coagulation”. Electrosurgical cutting comprises electric sparking to tissue with a cutting effect.
As used herein the term “electrosurgical handset or handset” is intended to mean an instrument comprising a surgical piece, such as a hand piece to which is attached an electrode (the “active electrode”), that may be detachable or fixed. The handset may be operated by a hand switch or foot switch. The active electrode is an electrically conducting element usually elongated in the form of a thin flat blade with a pointed or rounded distal end, or an elongated narrow cylindrical needle that may be solid or hollow with a flat, rounded, pointed or slanted distal end. The term “electrode” when used herein will generally refer to the active electrode. Electrodes as blade electrodes, loop or snare electrodes, needle electrodes and ball electrodes are available.
The handset is connected to a suitable electrosurgical generator, which generates the high frequency electrical energy necessary for the operation of the electrosurgical handset. An electrosurgical generator suitable for use with electrosurgical electrodes and handsets is disclosed in U.S. Pat. No. 3,699,967, the disclosure of which is incorporated herein by reference.
When an operation is performed on a patient with a handset, electrical energy from the electrosurgical generator is conducted through the active electrode to the tissue at the site of the operation and then through the patient to a return electrode, placed at a convenient place on the patient's body, to return via a patient pad or plate made of conductive material to the electrosurgical generator. A suitable circuit is illustrated schematically in U.S. Pat. No. 3,699,967.
Energizable surgical tools present a safety hazard to the patient and operating room personnel if the tools are activated when the environment has too high concentration of oxygen and/or flammable gases. Activation of an energized surgical tool can result in fire, burns and other tissue damage. The present design of those instruments has not entirely eliminated this hazard, and accidents of this nature may occur under unexpected circumstances.
In a surgical theater, energized surgical tools are used by a surgeon to operate on a patient's tissue and organs. Typical energy sources include high frequency electrical current, laser illumination, and ultrasonic vibration. A switch is typically provided to direct this energy to the surgical tool. The switch may be located on the hand piece of the surgical tool, or at another location such as near the surgeon's foot. Normally the switch is open and when the surgeon wishes to operate the tool, the switch is manually closed. The simple mechanical action on the switch is sufficient to direct energy to the tool.
An electrosurgical pencil with which this disclosure is particularly concerned is that shown in Design Pat. No. 393,067 the contents of which are incorporated by reference herein. Surgical pencils can have a pair of switches that start and stop the operation of the device or render the device operable from a first operating condition to a second operating condition. U.S. Pat. No. 5,035,695 discloses an extendable electrocautery surgery apparatus with an interlock switch, and the contents are incorporated herein by reference. The interlock switch is disposed to cut off the application of all electrical signals when the electrode conductor is in a retracted configuration. There are additional switches, which select between cutting and coagulation waveforms. These switches are shrouded against inadvertent activation when the electrode conductor is in a retracted configuration. U.S. Pat. No. 7,291,145 discloses a device to prevent operating room fire in an oxygen enriched atmosphere.
It is not known to measure the degree of oxygen or flammable gases in the environment of the tool.
There is a need to provide a device, system and method for measuring an oxygen and flammable gas level in the environment of the tool and to use this measure in an effort to prevent fires.